BMJ  2007;334:41-43 (6 January), doi:10.1136/bmj.39014.468900.BE

Practice

BMJ Masterclass for GPs

Dyspepsia and Helicobacter pylori

¹ Battersea, London

The first 150 words of the full text of this article appear below.

Introduction

Practical tips Dyspepsia is common, and most patients with dyspepsia do not need referral. Of those referred for endoscopy, some 30% are normal, and only 2% show malignancy. Mortality from endoscopy is 0.0001–0.0005% For dyspepsia without alarm symptoms, to "test and treat" for Helicobacter pylori or to give a proton pump inhibitor empirically is more economical than referral for endoscopy Review patients who have been taking acid suppression treatment for more than six weeks, to step down or stop treatment if feasible Gastric ulcers found during endoscopy usually need at least 4 weeks' treatment with a full dose proton pump inhibitor as well as H pylori eradication. Patients should then have a repeat endoscopy because of the small (2%) risk of cancer For patients at high risk of peptic ulcer disease (elderly, with a history of ulcers, or taking drugs that can cause ulcers) who test positive for H pylori, consider . . . [Full text of this article]

What should I already know about this condition?

Which test should I do?

What new evidence do I need to know about?

What new guidelines have been produced over the past two years?

Practical management tips

When should I refer my patient?

Common pitfalls

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